Delay of game

Sports offer a lot to young athletes: healthy activity, camaraderie, teamwork and hopefully, plain old fun. But injuries big and small can interfere. Random mishaps can’t always be avoided — they’re just part of the game. But relentless immersion in a single sport — specializing too soon, playing year-round and never taking a break — contributes to overuse injuries in kids. Here, experts describe how to treat or prevent sports injuries and offer ways parents can help.

‘I got it … in my eye.’

Taking a hard line drive or pitch in the face can be dangerous to a young ballplayer’s eyes. “If there’s any loss of vision, that’s an emergency until proven otherwise,” says Dr. Thomas Pommering, division chief of pediatric sports medicine at Nationwide Children’s Hospital in Columbus, Ohio. If your child has eye pain, bleeding, a severe headache or if you suspect the eye socket, or orbit, is broken, don’t wait. “You want to go to the emergency room because they can initiate care right away,” Pommering says. ER staff can call in an ophthalmologist for a thorough exam. The Vision Council offers sports eye safety advice.

Broken thumbs up?

Footballs take strange bounces, and football players take hard landings. Trauma to extremities — hands, fingers, shoulders, knees and ankles — are common. Fractures don’t always sideline players — it depends on severity, says Dr. Ricardo Colberg, a sports medicine and orthopedic physician at Andrews Sports Medicine and Orthopaedic Center in Birmingham, Alabama. With a thumb injury, for instance, “If it is a hairline fracture or sprain, you can immobilize it,” he says. “In some cases, you can cast it and let them play with a cast on.” However, he adds, if a fracture is displaced (with two bone parts misaligned) and needs to set, players generally sit out a few weeks to heal.

Tumbling trauma

Gymnasts thrill spectators as they flip and leap on the narrow balance beam. But sometimes gravity wins. “Obviously, some sports have higher risks,” Pommering says. “Like when you’re tumbling in gymnastics or cheerleading and the landings really have to be precise. Sports that involve collisions definitely result in the most injuries.” Cheerleading injuries have risen in the last several years, he says, in part because so many girls participate year-round in competitive leagues. Stunting with the top cheerleader falling from a pyramid is one mechanism for head and neck injuries. The American Association of Cheerleading Coaches and Administrators provides safety guidelines, including proper spotting and support during stunt and tosses.

Growth plates at risk

In kids, the growth plates, located near the ends of long bones, are vulnerable to fractures. “The growth plate is susceptible [because] it’s made up in part by cartilage, which is not as strong as bone,” Pommering explains. With an ankle sprain, for instance, “In a child who’s skeletally immature, the growth plate is just the weak link in the chain. And it could fracture or pull apart.” More severe injuries might cause growth arrest, when the growth plate shuts down. Potentially, limb-length differences could occur. Luckily, he says, the risk of growth-plate injuries is low in sports except for “the most significant incidents.”

Baseball elbow: no sure fix

Tears to the medial elbow ligament are a notorious example of overuse injuries that affect baseball players. “We’re getting kids in the seventh grade with Tommy John ligament tears, which we used to not see until junior or senior year of high school,” Colberg says. “But now we’re getting kids who’ve blown out their elbow.” Pitchers are most at risk, but any position can be affected. Too many players buy into the myth that Tommy John surgery will always make the elbow as good as new or even better. Don’t expect a “bionic” arm to pitch better or faster, Colberg warns: “It’s a great surgery, but it’s a salvage procedure.”

Troubling female triad

Girl runners, gymnasts and ballerinas are at highest risk for the female athlete triad, Colberg says. The three components are undernutrition and anorexia, menstrual changes and bone loss. In active girls who don’t get enough calcium for muscles to work properly, the body pulls calcium from the bones. Stress and malnutrition affect menstruation. Anorexia arises from self-image issues — girls feel like they’re not in shape enough and are pressured to lose weight and body fat. “If we want them to practice two hours a day, they need to nourish their bodies,” Colberg says. “Not only what they eat outside of practice, but how they’re replenishing their fluid and electrolytes in practice.”

Second-impact head injury

Football, soccer and other contact sports put kids at risk for head injury. High school girl basketball players are more vulnerable to concussions than boys, according to the Centers for Disease Control and Prevention. With concussion, inflammation builds around the brain. By returning to play too soon and receiving a second hit the head, “typically, the inflammatory reaction is going to be exponentially worse compared to the prior incident,” Colberg says. “So it puts you at risk for what’s called post-concussion syndrome.” It’s important for coaches, trainers, doctors and parents to recognize signs of concussion and make sure kids give their brains a chance to heal.

Overheating and dehydration

Hot climates take a toll on young athletes. Football players, who wear a lot of clothing and equipment, are at greatest risk for heat- or dehydration-related problems. Giving kids a few days to get acclimated to the environment, by starting practice in shorts and working up to helmets, shoulder pads and heavier pants, helps them tolerate heat better, Pommering says. “Hopefully these teams are practicing really early in the morning or in the evening,” he says. “Wearing wickable, breathable clothing helps. Free access to water, breaks during practice, athletic trainers on the sideline watching kids for signs of heat illness and dehydration — these are all important.”

Mental burnout

Tennis players and swimmers are among young athletes who practice so much — at all hours, competing in travel teams, tournaments and showcases, sometimes year-round — that mental burnout is possible. “We’re seeing a lot of kids that are under so much pressure to perform, and they’re specializing early, that they get tired and they don’t want to play the sport anymore,” Colberg says. Young kids should sample many activities and specialize in a single sport later, Pommering advises. Parents who encourage kids to wait until puberty or so limit their risk of overuse injuries, allow them to mature socially by interacting with kids in different environments and ease performance pressure.

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9 Sports Injuries That Sideline Kids originally appeared on usnews.com